| NPI | 1952067977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA65459) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00802700) |
| Enumeration Date | 2021-11-14 |
| Last Update Date | 2025-05-29 |